Intersection of http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage and http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage

This is the set of resources that conform to both PCT Coverage (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage) and PCT Coverage (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage).

Structure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*		Insurance or medical plan or a payment agreement Constraints: hrex-cov-1
Coverage.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
Coverage.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.extension		1..*	Extension	left: Additional content defined by implementations; right: Extension
Coverage.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Coverage.identifier	S This element must be supported. Σ This element is included in summaries.	0..1	Identifier	left: Also known as Member identifier; right: Member ID and other identifiers
Coverage.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance.
Coverage.type	S This element must be supported. Σ This element is included in summaries.	0..1	CodeableConcept	left: Coverage category such as medical or accident; right: Coverage category such as medical or accident. A coverage.type of `81` (Self-pay) MAY be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs. Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes
Coverage.policyHolder	Σ This element is included in summaries.	0..1	Reference(US Core Patient Profile | HRex Organization Profile | RelatedPerson)	Owner of the policy
Coverage.subscriber	Σ This element is included in summaries.	0..1	Reference(US Core Patient Profile)	Required if subscriber is a person that is not the beneficiary. When date of birth or gender are not known, omit Patient.birthDate and set Patient.gender to unknown.
Coverage.subscriber.extension		0..*	Extension	Additional content defined by implementations
Coverage.subscriber.reference	Σ This element is included in summaries.	0..1	string	Literal reference, Relative, internal or absolute URL
Coverage.subscriber.type	Σ This element is included in summaries.	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
Coverage.subscriber.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Coverage.subscriber.display	Σ This element is included in summaries.	1..1	string	left: Provide the name of the subscriber in Coverage.subscriber.display concatenating the subscriber’s prefix, given name, family name and suffix (in this order), each separated by a single space. If discrete name parts are required, a Patient resource SHALL be pointed to in Coverage.subscriber.reference.; right: Provide the name of the subscriber in Coverage.subscriber.display concatenating the subscriber's prefix, given name, family name and suffix (in this order), each separated by a single space. If discrete name parts are required, a Patient resource SHALL be pointed to in Coverage.subscriber.reference.
Coverage.subscriberId	S This element must be supported. Σ This element is included in summaries.	1..1	string	left: Subscriber ID; right: ID assigned to the subscriber
Coverage.beneficiary	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(HRex Patient Demographics | #sd-202-hrex-patient-demographics-us-core-patient)	left: Plan beneficiary; right: Patient or Plan Beneficiary
Coverage.dependent	S This element must be supported. Σ This element is included in summaries.	0..1	string	Dependent number
Coverage.relationship	S This element must be supported.	1..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
Coverage.period	S This element must be supported. Σ This element is included in summaries.	1..1	Period	Coverage start and end dates
Coverage.payor	S This element must be supported. Σ This element is included in summaries.	1..1		left: Issuer of the policy; right: Issuer of the policy. For Self-pay or uninsured this should be a reference to a patient or related person resource
Coverage.class	S This element must be supported.	1..*	BackboneElement	Additional coverage classifications
Coverage.class.extension		0..*	Extension	Additional content defined by implementations
Coverage.class.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.class.type	Σ This element is included in summaries.	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
Coverage.class.value	Σ This element is included in summaries.	1..1	string	Value associated with the type
Coverage.class.name	Σ This element is included in summaries.	1..1	string	Human readable description of the type and value
Coverage.order	Σ This element is included in summaries.	0..1	positiveInt	Relative order of the coverage
Coverage.network	Σ This element is included in summaries.	0..1	string	Insurer network
Coverage.costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
Coverage.costToBeneficiary.extension		0..*	Extension	Additional content defined by implementations
Coverage.costToBeneficiary.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.type	Σ This element is included in summaries.	0..1	CodeableConcept	Cost category Binding: ?? (required)
Coverage.costToBeneficiary.value[x]	Σ This element is included in summaries.	1..1		The amount or percentage due from the beneficiary
Coverage.costToBeneficiary.value[x].valueQuantity			Quantity(SimpleQuantity | ?gen-e2?)
Coverage.costToBeneficiary.value[x].valueMoney			Money(SimpleQuantity)
Coverage.costToBeneficiary.exception		0..*	BackboneElement	Exceptions for patient payments
Coverage.costToBeneficiary.exception.extension		0..*	Extension	Additional content defined by implementations
Coverage.costToBeneficiary.exception.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.exception.type	Σ This element is included in summaries.	1..1	CodeableConcept	Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.
Coverage.costToBeneficiary.exception.period	Σ This element is included in summaries.	0..1	Period	The effective period of the exception
Coverage.subrogation		0..1	boolean	Reimbursement to insurer
Coverage.contract		0..*	Reference(Contract)	Contract details
Documentation for this format